New Valve Replacement Through TAVR Lets an Active Senior Stay Active: J. Rob’s Story

J. Rob Walker has had the same doctor for a quarter century. This 90-year-old native Texan served in World War II, and when he came to Houston in 1965, he had risen into the executive ranks of the oil and gas industry. Walker says he knows a lot about decision-making under pressure. His motto: Stick with what you know and trust your colleagues — you know them and they know you.

When he chose Houston Methodist after a heart scare that turned out to be a heart murmur, Walker met Houston Methodist DeBakey Heart & Vascular Center cardiologist Dr. Mohammad Attar, who was brought in as a consultant by Dr. Antonio Gotto. Attar determined Walker's murmur did not require dramatic intervention. His physician’s explanation impressed Walker, and they developed and maintained a close relationship. Meanwhile, Attar kept an eye on his friend's health.

In 2000, Walker (and Attar) again noticed a heart problem. Tests showed an abnormality in Walker's aortic valve (blood wasn’t pumped properly) and also coronary artery disease (arteries providing blood to the heart muscle were narrowed); both conditions were unrelated to the initial problem that brought him to Houston Methodist, but now Walker required heart surgery.

“I had a bypass for that,” Walker said. “And Dr. Attar and I decided it made sense to hold off doing anything with the valve. I knew about the problems with a weak valve, but mine wasn't bothering me too much at that point.”

In early 2012, Walker was back at Houston Methodist. “I suddenly found myself short of breath,” Walker said. “I didn't like feeling that way.”

Walker had a physically active life before and after leaving the U.S. Marine Corps in 1945. His work required visiting oil fields up until his retirement. Walker said that even after he stopped working, he often walked at the air-conditioned local mall and went to the gym several times a week.

“I’ve always been up and about,” Walker said. “So, when I started feeling tired and not able to do things for very long, I got concerned. I'd never experienced anything like that.”

Walker consulted Attar. The bypass was okay, but the aortic valve problem had worsened and was no longer regulating blood flow adequately — this old problem was the cause of Walker’s symptoms. Attar brought in interventional cardiologist, Dr. Neal Kleiman, and cardiovascular surgeon who specializes in heart valve repair and replacement.

Because of Walker’s advanced age — and because he already had a bypass operation, the medical team recommended against opening his chest again. Attar, Kleiman and Ramlawi suggested a less-invasive procedure — the Sapien, a semi-synthetic valve developed by Edwards Lifesciences that the heart center’s Valve Clinic had begun implanting via a procedure called the transcatheter aortic valve replacement (TAVR) through a small incision in the thigh. Few hospitals and clinics have access to the valve, primarily because Edwards has been highly selective about the hospitals it allows to purchase the devices.

Walker agreed to TAVR, and the Houston Methodist doctors did more tests to ensure that the Sapien via TAVR was right for him.

“Houston Methodist is exceptional,” Walker said. “The last couple weeks before I got the valve, I was getting three to six tests a day. The tests weren’t bad, and they didn't take long. But I was impressed that at no time did I have to wait more than 5 to 10 minutes to see someone to get these done. It just seems like they’re always on schedule. I can’t do anything but say kind words about my experience during that time.”

On February 16, 2012, Walker got his active life back. The day before the procedure, he said things had gotten so bad, “There were very few things I could do without getting short of breath.” He felt better the day after surgery and was discharged after five days. 

“The first thing I noticed when I got home was that I didn't have the same shortness of breath,” Walker said. “This may be a small thing, but I also noticed my ankles didn't swell up like they used to, which made it hard getting my boots on and off, and I also had more energy.”

Walker’s doctors advised him to stay active following the procedure, but to ease slowly into more rigorous physical activity. Walker says he has felt improvement every day since the procedure and is back to the mall and the gym.


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